Nuffield Department of Primary Care Health Science; NIHR Oxford Biomedical Research Centre.
Bristol Myers Squibb Pharmaceuticals Ltd.
Br J Gen Pract. 2020 Mar 26;70(693):e285-e293. doi: 10.3399/bjgp20X708245. Print 2020 Apr.
Chronic kidney disease (CKD) is a largely asymptomatic condition of diminished renal function, which may not be detected until advanced stages without screening.
To establish undiagnosed and overall CKD prevalence using a cross-sectional analysis.
Longitudinal cohort study in UK primary care.
Participants aged ≥60 years were invited to attend CKD screening visits to determine whether they had reduced renal function (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m or albumin:creatinine ratio ≥3 mg/mmol). Those with existing CKD, low eGFR, evidence of albuminuria, or two positive screening tests attended a baseline assessment (CKD cohort).
A total of 3207 participants were recruited and 861 attended the baseline assessment. The CKD cohort consisted of 327 people with existing CKD, 257 people with CKD diagnosed through screening (CKD prevalence of 18.2%, 95% confidence interval [CI] = 16.9 to 19.6), and 277 with borderline/transient decreased renal function. In the CKD cohort, 54.4% were female, mean standard deviation (SD) age was 74.0 (SD 6.9) years, and mean eGFR was 58.0 (SD 18.4) ml/min/1.73 m. Of the 584 with confirmed CKD, 44.0% were diagnosed through screening. Over half of the CKD cohort (51.9%, 447/861) fell into CKD stages 3-5 at their baseline assessment, giving an overall prevalence of CKD stages 3-5 of 13.9% (95% CI = 12.8 to 15.1). More people had reduced eGFR using the Modification of Diet in Renal Disease (MDRD) equation than with CKD Epidemiology Collaboration (CKD-EPI) equation in the 60-75-year age group and more had reduced eGFR using CKD-EPI in the ≥80-year age group.
This study found that around 44.0% of people living with CKD are undiagnosed without screening, and prevalence of CKD stages 1-5 was 18.2% in participants aged >60 years. Follow-up will provide data on annual incidence, rate of CKD progression, determinants of rapid progression, and predictors of cardiovascular events.
慢性肾脏病（CKD）是一种肾功能减退的无症状疾病，如果不进行筛查，可能直到晚期才被发现。
通过横断面分析确定未诊断和总体 CKD 的患病率。
英国初级保健中的纵向队列研究。
邀请年龄≥60 岁的参与者进行 CKD 筛查，以确定他们是否存在肾功能下降（估计肾小球滤过率[eGFR]＜60 ml/min/1.73 m 或白蛋白：肌酐比值≥3 mg/mmol）。那些已经患有 CKD、eGFR 较低、有白蛋白尿证据或两次筛查呈阳性的患者接受基线评估（CKD 队列）。
共招募了 3207 名参与者，861 名参加了基线评估。CKD 队列包括 327 名现有 CKD 患者、257 名通过筛查诊断的 CKD 患者（CKD 患病率为 18.2%，95%置信区间[CI]为 16.9 至 19.6）和 277 名边界/短暂性肾功能下降患者。在 CKD 队列中，54.4%为女性，平均标准偏差（SD）年龄为 74.0（SD 6.9）岁，平均 eGFR 为 58.0（SD 18.4）ml/min/1.73 m。在 584 名确诊 CKD 患者中，44.0%是通过筛查诊断的。在 CKD 队列中，超过一半（51.9%，447/861）在基线评估时被归入 CKD 3-5 期，这表明 CKD 3-5 期的总体患病率为 13.9%（95%CI=12.8 至 15.1）。在 60-75 岁年龄组中，使用改良肾脏病膳食研究（MDRD）方程的人比使用 CKD 流行病学协作组（CKD-EPI）方程的人有更多的 eGFR 下降，而在≥80 岁年龄组中，使用 CKD-EPI 的人有更多的 eGFR 下降。
这项研究发现，大约 44.0%未经筛查的 CKD 患者未被诊断，如果不进行筛查，60 岁以上人群的 CKD 1-5 期患病率为 18.2%。随访将提供有关年发病率、CKD 进展率、快速进展的决定因素和心血管事件预测因素的数据。
Zotero 插件
